- 作者：Brian D. Odom ; M.C. Mir ; Scott Hughes ; Cedric Senechal ; Alexis Santy ; Remi Eyraud ; Andrew J. Stephenson ; Kelly Ylitalo ; Ranko Miocinovic
- 刊名：Urology
- 出版年：February, 2014
- 年：2014
- 卷：83
- 期：2
- 页码：364-368
- 全文大小：245 K
Objective
To compare the outcomes of active surveillance (AS) series between African American men (AAM) and non-AAM diagnosed with low-risk prostate cancer at 3 medical centers.Methods
Between 2005 and 2012, 214 men accepted AS on the basis of favorable clinical features and parameters after initial and repeat biopsy. Failure was defined as increase in Gleason score >6, total positive cores >33%, maximum cancer volume in any core >50%, or a prostate-specific antigen >10聽ng/mL. Disease progression and overall AS failure were compared between the 2 groups.
Results
Of 214 men, 75 were excluded, leaving 67 AAM and 72 non-AAM on AS. Median age at diagnosis was 64 and 67聽years for AAM and non-AAM, respectively, and median follow-up was 34 and 46聽months, respectively. During this time, 44 AAM (66%) remained on AS, and 23 (34%) underwent treatment, of whom 6 (26%) were treated by patient choice and 17 (74%) because of disease progression. In the non-AAM group, 59 (82%) men remained on AS, and 13 (18%) underwent treatment, 8 (62%) were treated by patient choice and 5 (38%) because of disease progression. The 3-year freedom from overall treatment was 74% and did not differ by race (P聽= .06). The 3-year freedom from disease progression was 85%, where AAM were at significantly higher risk of disease progression (hazard ratio聽= 3.8; 95% confidence interval: 1.4-10.4; P聽= .01).
Conclusion
Our study suggests a higher disease progression rate in AAM who choose AS for low-risk prostate cancer compared with non-AAM, signifying a potential need for closer follow-up and more stringent enrollment criteria in AAM.